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Home My WebLink About203746 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $520.82 o CARMEL, INDIANA 46032 PO BOX 183019 COLUMBUS OH 43218 -3019 CHECK NUMBER: 203746 CHECK DATE: 11/2112011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 065129116111 520.82 065 129 -116 www. sheiffleetcard .accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065 129 -116 12 065129116111 SHELL CARD CENTER P.O. BOX 689081 CLOSING DATE, DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081 11 -04 -2011 11.29 -2011 29 TELEPHONE: 1 -800. 377-5150 FAX: 1.515- 226.4045 NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE 550.66 .00 866.21 896.05 CR .00 520.82 A PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 11 -29 -2011 CARD CTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION NUMBER DATE TIME ID CD CD TAX AMOUNT 10 -28 PAYMENT THANK YOU 866.21 CRR 0003 10 -09 10:20 0408161 8924 E 116TH ST FISHERS IN 11.773 8 UNL 2.15 39.90'/ 11.773 GAL UNLEADED $39.90 TOTAL CARD 0003 11.773 2.15 39.90 w• 0009 10 -11 11:31 0595629 1230 S RANGELINE RD CARMEL IN 25.516 8 UNL 4.67 84.18% 25.516 GAL UNLEADED $84.18 0009 10 -12 10:12 0728816 6955 S EMERSON INDIANAPOLIS IN 10.051 8 UNL 1.84 33.17✓ 10.051 GAL UNLEADED $33.17 0009 10 -12 19:39 0056119 4624 LAFAYETTE RD INDIANAPOLIS IN 9.082 8 UNL 1.66 29.70 9.082 GAL UNLEADED $29.70 0009 10 -14 05:36 0969097 4221 S EMERSON AVE INDIANAPOLIS IN 19.522 8 UNL 3.57 69.48 19.522 GAL UNLEADED $69.48 0009 10 -21 19:27 0722850 7788 E 96 FH ST FISHERS IN 7.580 8 UNL 1.39 26.07 Y 7.580 GAL UNLEADED $26.07 0009 10 -24 1249 0908376 2040 E WASHINGTON INDIANAPOLIS IN 14.904 8 UNL 2.73 49.02 14.904 GAL UNLEADED $49.02 0009 10.26 09:59 0627919 7902 W 10TH ST INDIANAPOLIS IN 9.152 8 UNL 1.67 30.01 9.152 GAL UNLEADED $30.01 0009 11 -01 0850 0805044 7788 E 96TH ST FISHERS IN 8.632 8 UNL 1.58 30.04 Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8- Electronic Sale at Pump 2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale SCHEDULE OF LATE FEE PERIODIC RATE ANNUAL MONTHLY MINIMUM BALANCE SUBJECT TO LATE FEE (MONTHLY) PERCENTAGE RATE SEE REVERSE SIDE 0.000% 0.00% 0.00 .00 6057 0008 GUG 1 7 2 111104 9366 8015 SH33 5083 N OTICE: SEE REVERSE SIDE FO R IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0005083 Page 1 of 2 FLET2GUG Information About Your Account Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7 days a week. Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement. Proper Form. For a payment sent by mail or courier to be in proper form, you must: Enclose a valid check or money order. No cash or foreign currency please. Include your name and account number on the front of your check or money order. If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Optional Pay by Phone Service. You may use this optional service any time to make a payment by phone. You will be charged $14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time, your payment will be credited as of the next day. We may process your payment electronically after we verify your identity. This Account is Issued by Citibank, N.A. PLOCOMM Rev 07111 I www. shelifleetcard .accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065 129 -116 12 065129116111 SHELL CARD CENTER P.O. BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081 11 -04 -2011 11 -29 -2011 29 TELEPHONE: 1.8003775150 FAX: 1 -515- 226 -4045 CARD TBANSACTIQU TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION NUMBER DATE TIME ID CD CD TAX AMOUNT 8.632 GAL UNLEADED $30.04 0009 11 -02 10:17 0196485 8501 E WASHINGTON ST INDIANAPOLIS IN 14.880 8 UNL 212 50.00 14.880 GAL UNLEADED $50.00 TOTAL CARD 0009 119.319 21.83 401.67 0010 10 -14 05:05 0057554 9599 N MERIDIAN ST INDIANAPOLIS IN 16.461 8 UNL 3.38 62.75 V 18.461 GAL UNLEADED S62.75 0010 10 -21 11:28 0874669 9611 ALLISONVILLE RD INDIANAPOLIS IN 13.553 8 UNL 2.48 46.34 13.553 GAL UNLEADED $46.34 TOTAL CARD 0010 32.014 5.86 109.09 GRAND TOTAL 163.106 29.84 550.66 FEDERAL EXCISE TAX 163.1 GALLONS GASOLINE 29.84 CR Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8 Electronic Sale at Pump 2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale 6057 0008 GUS 1 7 2 111104 9366 8015 SH33 5083 NO S RE V E RSE S IDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0005083 Page 2 of 2 FLET2GUG At no= Information About Your Account Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7 days a week. Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement. Proper Form. For a payment sent by mail or courier to be in proper form, you must: Enclose a valid check or money order. No cash or foreign currency please. Include your name and account number on the front of your check or money order. If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Optional Pay by Phone Service.. You may use this optional service any time to make a payment by phone. You will be charged $14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time, your payment will be credited as of the next day. We may process your payment electronically after we verify your identity. This Account is Issued by Citibank, N.A. PLOCOMM Rev 07111 VOUCHER NO. WARRANT NO. ALLOWED 20 Shell Fleet Plus Processing Center IN SUM OF P.O. Box 183019 Columbus, OH 43218 -3019 $520.82 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1110 65129116111 42- 314.00 I $520.82 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, November 15, 2011 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11/04/11 65129116111 monthly payment $520.82 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 20 Clerk- Treasurer